Seasonal depression (SAD): Symptoms, causes, and treatment

HARTFORD — As Connecticut residents enjoyed the long days of summer, mental health experts warned that now is the time to prepare for seasonal affective disorder, a form of depression that reliably returns with the darker months and shorter daylight hours, according to Mayo Clinic guidance and local clinicians.[2][4] Seasonal affective disorder, or SAD, typically begins in the late fall, worsens through winter, and lifts in spring, bringing symptoms such as low energy, oversleeping and intense carbohydrate cravings that can disrupt work, relationships and daily life if left untreated, according to the Mayo Clinic.[2][3]

Mayo Clinic described SAD as “more than feeling sad” and classified it as a subtype of major depression that follows a predictable seasonal pattern, driven in part by reduced sunlight that affects brain chemicals regulating mood and sleep.[2][4] “The good news is that when people recognize the pattern and seek help early, treatments like bright light therapy, psychotherapy and, in some cases, medication can make a substantial difference,” said Dr. Craig Sawchuk, a Mayo Clinic psychologist who specializes in mood disorders.[1][2][4]

According to Mayo Clinic materials, SAD symptoms in fall and winter can include feeling depressed most of the day nearly every day, low energy, losing interest in activities, sleeping too much, craving carbohydrates, weight gain, and difficulty concentrating.[2][3] In more severe cases, people may experience feelings of hopelessness or worthlessness and, at times, have thoughts of death or suicide, which clinicians emphasized require urgent evaluation by a health professional.[2][4] Mayo Clinic experts said the exact cause remains unclear, but research points to reduced sunlight disrupting the body’s internal clock, lowering serotonin levels that influence mood and increasing melatonin levels that regulate sleep, contributing to fatigue and oversleeping.[2][4]

Connecticut’s latitude and long, overcast winters may make these seasonal changes especially noticeable, clinicians said, though SAD can affect people in any region. Mayo Clinic noted that women are diagnosed with SAD more often than men, and the condition frequently begins in young adulthood, often recurring year after year unless proactively treated.[2][3] “People often write it off as ‘just winter blues,’ but when symptoms start impacting work performance or relationships, that’s when we consider it a clinical depressive episode with a seasonal pattern,” said Dr. Sawchuk.[4]

One of the most studied treatments for SAD is bright light therapy, which involves daily exposure to a specially designed light box that mimics natural outdoor light, according to Mayo Clinic.[1][2][6] Dr. Sawchuk said one effective approach is using a 10,000-lux light box within the first hour of waking up for about 20 minutes, with the box placed at arm’s length and the eyes open but not looking directly into the light.[1][6] “That tends to be about the sweet spot of exposure to that light,” he said, noting that many people continue light therapy into spring or until their mood naturally improves.[1]

Mayo Clinic guidance emphasized that light boxes for SAD should filter out most ultraviolet (UV) light and be used under medical supervision, especially for people with bipolar disorder or eye conditions.[2][6] The clinic advised patients to discuss light therapy with their health care provider before starting and to monitor for potential side effects such as eyestrain, headache or irritability, which are typically mild and improve with adjustments in duration or distance.[2][6] Psychiatrists also cautioned that because SAD is a form of depression, treatment plans often combine light therapy with psychotherapy and, when appropriate, antidepressant medication for more robust relief.[2][4][8]

Psychotherapy, particularly cognitive behavioral therapy (CBT), has also shown effectiveness for SAD, according to Mayo Clinic and affiliated health system publications.[2][3][4] CBT helps patients identify and change negative thought patterns and behaviors that can worsen seasonal depression, such as withdrawing from social activities or avoiding outdoor time during daylight hours.[3][4] Mayo Clinic experts said CBT can be especially helpful in teaching coping strategies to use each year as fall approaches, making it a valuable option for people who experience recurrent seasonal episodes.[3][4]

Medication is another evidence-based option, particularly for individuals with moderate to severe symptoms or a strong history of seasonal depression, according to Mayo Clinic.[2][4] Selective serotonin reuptake inhibitors (SSRIs) are often prescribed, and in some cases clinicians recommend starting medication before symptoms typically emerge in the fall and continuing through winter.[2][4] Providers stressed that all antidepressants should be monitored closely, and any changes in mood, sleep or suicidal thinking should be reported promptly to a clinician.[2][4]

Mayo Clinic guidance also underscored lifestyle measures that can support formal treatment, including exercising regularly, normalizing sleep patterns and maximizing exposure to natural light.[2][3][4] Research cited by Mayo Clinic Health System shows that exercising for about 20 minutes at least three days a week can have similar effectiveness to an antidepressant for some people with depression, and exercising outdoors during daylight can enhance these benefits.[3][4] The clinic further recommended getting outside for 15 to 20 minutes when the sun is out, opening blinds to make indoor spaces brighter, and sitting near windows during the day to help reset the body’s internal clock.[3][4]

Local mental health providers said early planning is crucial for Connecticut residents who recognize a seasonal pattern in their mood. “If someone knows that every November they start sleeping more, craving carbs and feeling like they’re ‘hibernating,’ we encourage them to talk with their clinician in late summer or early fall about a preventive plan,” said a Hartford-based psychiatrist, referencing Mayo Clinic guidance on early intervention.[2][3][4] Such plans may include scheduling psychotherapy, arranging access to a light box, and reinforcing healthy routines around sleep, exercise and social connection.[2][3][4]

Mayo Clinic materials advised people to monitor their own patterns carefully, including when symptoms start each year, what improves or worsens them, and any additional mental or physical health issues that could affect mood.[2] Officials said sharing this information with a primary care provider or mental health professional can help refine diagnosis and tailor treatment, especially because symptoms of SAD can overlap with other conditions such as major depression or thyroid disorders.[2][4] The clinic also urged individuals not to self-diagnose or self-treat without medical input, particularly when using light therapy devices sold online, which vary in quality and safety features.[2][6]

For Connecticut residents concerned about seasonal mood changes, Mayo Clinic experts stressed that SAD is both recognizable and treatable when addressed promptly.[2][4] “People do not have to wait until January when they feel overwhelmed,” Dr. Sawchuk said, noting that early recognition in the fall and coordinated care with local clinicians can help prevent seasonal depression from significantly disrupting work, school or relationships.[1][2][4] As the state moves toward another winter with predictably shorter days, clinicians urged residents who notice recurring seasonal patterns to reach out to their health care providers now and discuss concrete steps to reduce their risk of winter depression.